Licensure laws and other barriers to telemedicine and telehealth: an urgent need for reform

Abstract

A few weeks ago, a man in his mid-60s with worsening pulmonary fibrosis sought the expertise of a specialist physician (GR) via a telemedicine visit. The patient took the visit in his car by the roadside. Although a telemedicine visit in a car is never ideal, it was particularly difficult because he was using supplemental oxygen at 6 L/min and his oxygen saturation was only 90%; every cough during the conversation led his oxygen saturation to drop even further. The patient was not in the car by his choice or because his pulmonologist recommended it—both would have preferred the telemedicine visit from the comfort of the patient's home.